Hridroga /Heart Disease in Ayurvedic classics. Published Research papers. Medications for the treatment.

1. DR. BIKASH MAHARJAN
ASST. PROFESSOR
DEPT. OF KAYA CHIKITSHA
PAMCARC

2.  First known description regarding the importance of hridaya yantra can be traced
back to athrava veda. (atharva veda 19/9/4) It describes their understanding
regarding the functioning of the heart and its relation to life and death.
 The term HRIDAYAMAYA describes to the desires involving the heart.
 In Yajurveda there is a very good reference stating that the heart resided in the
chest between neck and naval, 12 fingers in breadth above the naval. Also the
central situation of the heart was mentioned along with the deviation to the
midline. It is said to resemble a large lotus kept upside down with its tip to the
left.

3.  Indha - Pulmonary aorta
 Virat - heart
 Lohita pinda - flaps of auriculo-ventricular
 Antar hrudaya jalaka -network with the heart-Chordae tendinae
 Sritih sanchari - circulatory opening
 Kesah sahastrardha nadi - blood capillaries

4.  Charaka gave two synonyms to hrudaya namely ‘mahat’ and ‘artha’(C.Su.30/7)
 Hridaya and relation to srotas in viman sthana :
 Hridaya has been described as the origin of the prana vaha srotas along with rasa
vaha srotas. (C.Vi. 5/7)
 It has been described as one of the trimarmas in chikitsa sthana, Trimarmeeya
adhyaya chikitsa. ( ref- ch.chi 26)
 Above references from viman sthan clearly state the importance of heart by
describing it as the origin of the pranavaha srotas and hence its role in preserving
life is identified.similarly describing it as the origin of the rasavaha srotas,its
importane in circulation has been identified.

5.  In Susruta Samhita, the heart has been described as the seat of chetana. Ref su.sa
4/30
 By describing it as the seat of chethana, it implies that normal functioning of the
heart is responsible for chethana( life) and vice versa.
 Moreover, Susruta Samhita clearly describes the pain of Myocardial Ischaemia
(angina pain) in such a way that it cannot be bettered even now.
 Dhanvantari describes the symptoms of the heart disease and impending the death
due to heart attacks.
 Patient may feel pricking pain and pain may be so severe resembling the pain of
splitting the chest into two halves with an axe.

6.  In astanga hrudaya the set of vyana vayu has been described with resemblance to
the heart along with its functions and relation to circulation (ref: A.H.12/6 )
 Sarangadhara samhitha contains the earliest description of circulation and
respiration and their relation. He says that nabhigata pranavata comes out
through kantha after touching the interior of the heart- HRIT KAMALANTARA
to take Vishnu padamurta or ambara peeyusha (oxygen). After having taken the
peeyusha it goes in very quickly and nourishes the body, maintains life and
lightens the jatharagni. ( ref- Sa. Sam.Pur. Kha. 6/89,90)

7. Bhava misra was the first person to classify and describe over 50 drugs as hridyam.
Moreover he was the first person to advocate the use of arjuna churna along with
milk or ghee in various heart diseases.
 Bhaisajya ratnavali is an extensive compilation of various herbal drugs and
herbo-mineral drugs that can be used in hridroga in general and vataja hridroga
in particular.

8. 1. AHARAJA NIDANA
 ADHYASAN : In spite of incomplete digestion of food, consuming more food
 USHNA SEVANA : over indulgence in ushna padarthas.
 MADYATI SEVANA : Excessive intake of alcohol.
 Excessive intake of Kashaya, tikta rasas.

9. 2. VIHARAJA NIDANA:
 DIVA SWAPNA : sleeping during daytime particularly after consuming food.
 AVYAYAMA : lack of physical activity or excessive
 ATIVYAYAMA : excessive indulgence in exercise.
 VEGA DHARANA or VEGA NIRODHA : postponing 13 natural urges as described in
Ayurveda .
 Passing out of apana vata if suppressed creates upward pressure on the heart.
 There is a special reference that srama swasa nigraha in particular leads to heart
diseases.
 DHUMA PANA : Excessive smoking.
 ATI MAITHUNA : Excessive indulgence in sex.

10. MANASIKA KARANAS
 CINTA : excessive worry.
 BHAYA : Excessive fear- causes vata prakopa
 ATIKRODHA : Excessive anger- causes pitta prakopa
 TRASA : trouble
OTHER CAUSES :
1. ABHIGHATA- Injury especially to heart and blood vessels.
2. GADATICHARA- Chronic diseases
3. AMA – incomplete or improperly digested food
4. KARASANI – chronic debilitating diseases characterized by acute loss of
weight.
5. ATI VAMANA
ATI VIRECHANA causes vata prakopa
ATI VASTI

11.  HRIDROGA can be broadly classified as follows –
 Nija
 Agantuja
 Nija type of Hridriga can be further divided into 4 varieties-
 a.VATAJA HRIDROGA
 b. PITTAJA HRIDROGA
 c.KAPHAJA HRIDROGA
 d.SANNIPATAJA HRIDROGA
 KRIMIJA HRIDROGA comes under the agantuja hridroga

12. HRIDSULA/HRIDROGA
SROTORODHA, DHAMANI PRATICHAYA
SAMA RASA DHATU UTPATTI
AGNIMANDHYA
AHARA VIHARA VYATIKRAMA
NIDANA SEVANA
AHARAJA VIHARAJA

13. KRIMIJA HRIDROGA
BHAKSHANA OF HRIDAYA BY KRIMI
UTPATI OF KRIMI DUE TO KLEDA OVER GRANTHI
UTPATTI OF KLEDA
GRANTHI UTPATTI OVER HRIDPRADESHA
TILA, GUDA, KSHEERA ATI SEVANA
TRIDOSHAJA HRIDROGA

14.  DOSHA - VATADI TRIDOSHAJA,VATA PRADHANA
 DUSHYA -RASA, MEDA
 SROTAS -RASAVAHA, PRANAVAHA
 ADHISTANA -HRIDAYA
 SROTODUSHTI -SANGA
 SWABHAVA - CHIRAKARI
 AGNIDUSHTI -AGNIMANDYA
 SADYAASADYATHA-YAPYA

15.  Hridaya ayamyata
 Hridaya tudyata
 Hridaya nirmathyata
 Hridaya deeryata
 Hridaya sphotyata
 Hridaya patyata

16. Tamo darsana
Daha
Moha
Santrasa
Taapa Vriddhi
Jwara
Pita bhavata
Trishna
Osha
Chosha
Hridaya klama
Dhumayana

17. Hridaya sthabdtha
Hridaya gurutha
Hridaya sthaimithya
Kapha praseka
Jwara
Kasa
Tandra
Aruchi
Agni mardavam
Asya maduryam

18. Teevra toda
Kandu
Uthklesha
Steevanam
Hrillasa
Tamas
Aruchi
Syava netrata
Sosha

19.  KLOMA SADAM- wasting of kloma
 BHRAMA- Giddiness
 SOSHA- wasting

20. According to Bhela
 Vataja, pittaja, kaphaja- sadya
However hridroga being a marmasruta vyadhi is
considered as Kasta sadhya or asadhya.

21. 1. In Vataja hridroga, before vamana is undertaken, sneha pana has to be
administered to the patient then the actual procedure has to carried out by
administering DWIPANCHAMOOLADI kwatha along with sneha and lavana.
2. In Paittika hridroga, lepana and parisechana with sitala drugs should be done.
Multethi and kutaki should be mixed with misri jala for drinking.
3. In Kaphaja hridroga, first swedana karma is to be performed followed by vamana
by administering a mixture of vacha and nimba kashaya.

22.  4. In Krimija Hridroga, Sneha mishrita mamsa, rice and curd
should be mixed with tila churna and intook for 3 days.
 After proper oleation, virechana should be done.
 Langhana should be followed by pachana and krimi roga should
be treated with krimighna medicines.

23. 2. VATI
 Kankayana vati nikumbadya
gutika
 Abaya vataka shambukadya
gutika kalyanaka gutika
 Laghu shiva gutika
 Sapta chatwari satika guggulu
 Arogya lavana
 Surya chandra prabha gutika
1. RASA/BHASMA
 Mrigasrungi bhasma
 Ratna vijaya parpati
 Hridayanarva Rasa
 Chintamani rasa
 Chandrakanta rasa
 Mahakalyana rasa
3. CHURNA
 Dadimastaka eladya churna
 Vidangadya churna
 Surasadya churnam
 Lavana bhasakara churnam
 Hingwastaka churnam
 Vyoshadhi churnam

24. 5. ASAVA/ARISTA
 Lohasava
 Kanakarishta
4. KWATH
 Kaserukadi kwath
 Katphaladi kwath
6. GHRITA
 Arjuna ghrita
 Dadimadya ghrita
 Devadaryadya ghrita
 Jivakadi ghrita
 Kamadeva ghrita
 Lasuna ghrita
 Mahatikta ghrita
7. TAILA
 Prasarani Taila
 Sukumari taila
 Syonaka taila
8. LEPA
 Manashiladi Lepa
 Switranashak Lepa
 Karviradi Lepa

25.  It was observed that there was significant improvement in clinical features of LVD
like breathlessness, chest pain,andfatigability after the therapy in Group I & III,
in which Cardi-16 was administered.[Table 2, 3 &4]. Patients subjected to the
treatmentwith Cardi -16 also reported increase in their urine output. Reduction in
diastolic blood pressure was also observed in patients with mild hypertension.
Probably this way the drug has facilitated reduction in afterload and improvement
indiastolic function. Drug has also exhibited positive inotropic activity.

26.  Conclusion
HFRT promises significant
therapeutic effects with improvement
in MAC and no safety concerns. This
non-invasive ayurvedic regime can be
considered as a good candidate to be
included in maintenance treatment of
patients with CHF.

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